EPIDEMIOLOGY OF OSTEOPOROSIS IN WOMEN WITH LUPUS - MAMDC PROJECT

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。本研究的具体目的是：1)估计240名狼疮妇女与200名年龄、种族和绝经状态相匹配的对照组之间髋腰椎骨密度（BMD）的差异；2)在控制传统低骨密度危险因素后，确定狼疮女性狼疮危险因素与低骨密度的关系；3)对参加横断面研究的受试者进行为期两年的随访，以估计狼疮妇女与按年龄、种族和绝经状态匹配的对照组之间髋部和腰椎骨质损失率的差异；4)在控制低骨密度的传统危险因素后，确定狼疮危险因素与狼疮女性骨质流失率增加的关系。本研究要检验的假设是：1)狼疮女性髋部和脊柱的骨密度低于对照组；1b)狼疮对白人女性髋部和脊柱骨矿物质密度的负面影响大于非裔美国女性；2a)低骨密度的传统危险因素（多方和绝经状态、月经周期不规律或过早绝经、避免口服避孕药和/或激素替代疗法、体力活动水平较低、维生素D水平降低）与狼疮女性髋部或腰椎骨密度较低相关；2b)在控制低骨密度的传统危险因素后，狼疮危险因素（较大的疾病活动性、较大的疾病严重程度、较高的皮质类固醇负担、使用抗惊厥药物和存在肾脏疾病）与狼疮妇女髋部或腰椎骨密度较低相关；(3)与对照组随访两年相比，患有狼疮的女性在患狼疮的额外两年期间髋关节和脊柱骨质流失加速；狼疮对髋部和脊柱骨质流失率的影响在白种人中比在非洲裔美国妇女中更大；4a)传统的骨质疏松危险因素（上文2a中提到）与狼疮女性骨质流失加速有关；和4b)狼疮危险因素（上文2b中提到）在控制了低骨密度的传统危险因素后，与狼疮女性髋部或腰椎加速骨质流失有关。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The specific aims to be addressed in this study are: 1) To estimate the differences in bone mineral density (BMD) at the hip and lumbar spine between 240 women with lupus and a comparable control group of 200 women matched by age, race, and menopause status; 2) To determine the association of lupus risk factors with low BMD in women with lupus, after controlling for traditional risk factors for low BMD; 3) To follow the subjects entered in the cross-sectional study over a two year period in order to estimate the difference in the rate of bone loss at the hip and lumbar spine between women with lupus and a comparable control group matched by age, race, and menopause status; and 4) To determine the association of lupus risk factors with increased rates of bone loss in women with lupus, after controlling for traditional risk factors for low BMD. The hypotheses to be examined in this study are: 1a) women with lupus have lower BMD at the hip and spine than matched controls; 1b) the negative effect of lupus on bone mineral density at the hip and spine is greater in Caucasian than in African-American women; 2a) traditional risk factors for low BMD (multiparty and menopause status, irregular menstrual cycles or premature menopause, avoidance of oral contraceptives and/or hormone replacement therapy, lower physical activity level, and decreased vitamin D levels) are associated with lower BMD at the hip or lumbar spine in women with lupus; 2b) lupus risk factors (greater disease activity, greater disease severity, higher corticosteroid burden, use of anticonvulsant drugs, and the presence of renal disease) are associated with lower BMD at the hip or lumbar spine in women with lupus, after controlling for traditional risk factors for low BMD; 3a) women with lupus have accelerated bone loss at the hip and spine during two additional years of lupus disease compared with matched controls followed for two years; 3b) the effect of lupus on the rate of bone loss at the hip and spine is greater in Caucasian than in African-American women; 4a) traditional osteoporosis risk factors (mentioned in 2a above) are associated with accelerated bone loss in women with lupus; and 4b) lupus risk factors (mentioned in 2b above) are associated with accelerated bone loss at the hip or lumbar spine in women with lupus, after controlling for traditional risk factors for low BMD.